Despite prevention programs in schools, legal restrictions at restaurants and bars, and repeated health warnings on TV, nearly one in four Americans continues to smoke. For these people, lung cancer and emphysema could be lurking in their not-so-distant future, and evidence now suggests that smoking might also contribute to other conditions, including back pain.

If you smoke and have a history of back problems, smoking might be making those problems worse.

Results of a questionnaire mailed to 1,471 young me and women diagnosed with adolescent scoliosis (curvature of the spine) and 1,750 mean and women without scoliosis revealed that smoking increased reported back pain not only in men and women with scoliosis, but also in healthy women. Back pain was also more frequent and more intense among smokers compared with nonsmokers in the study group.

These results suggest that smoking is associated with back pain, and that the impact may be even greater in people with spinal conditions. All the evidence shows that smoking is addictive, but picking up that first cigarette is a choice. Make the right choice -- it's much less painful in the long run.